August 26, 2021
Transition to Value
  • CMS announced that ACOs participating in the Medicare Shared Savings Program in 2020 earned performance bonuses totaling nearly $2.3 billion and saved Medicare $1.9 billion. Sixty-seven percent (or 345) of the 513 ACOs earned shared savings payments in 2020. ACOs participating in downside risk models were more likely to earn the bonus payments. In particular, 88 percent of the two-sided risk models and 55 percent of one-sided risk models earned the performance payment. Currently, over 12.1 million Medicare fee-for-service beneficiaries receive care from a health care provider participating in a Medicare ACO. (Press release here; Articles here and here)
  • Blue Cross and Blue Shield of North Carolina announced that its value-based payment model generated $197 million in cost savings in 2020. The program includes 11 hospitals and more than 870 independent primary care practices. Providers in the Blue Premier program saw a 15 percent reduction in hospital readmissions when compared to 2019 metrics. Additionally, providers increased the number of colorectal screenings completed in 2020 by 10,000 compared to the year before. (Press release here)